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THORACIC CAVITY. RESPIRATORY DIAPHRAGM. Diaphragm. A diaphragm is a muscular sheet with an inferior and a superior fascia: Superior fascia = parietal thoracic fascia. Inferior fascia = transversalis fascia. Separates thorax and abdomen. In moderate expiration:

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THORACIC CAVITY

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Thoracic cavity l.jpg

THORACIC CAVITY

RESPIRATORY DIAPHRAGM


Diaphragm l.jpg

Diaphragm

  • A diaphragm is a muscular sheet with an inferior and a superior fascia:

    Superior fascia = parietal thoracic fascia.

    Inferior fascia = transversalis fascia.

  • Separates thorax and abdomen.

  • In moderate expiration:

    Reaches level of 5th rib on right side and 5th IC space on left.


Diaphragm origins l.jpg

Diaphragm Origins

  • Sternal part:

    Xiphoid process.

  • Costal part:

    Lower 6 ribs and cartilages.

  • Lumbar part:

    Lumbar vertebrae and crura:

    Right: L1-L3

    Left:L1-L2


Central tendon l.jpg

Central Tendon

  • “Y-shaped”

  • Attaches to lumbar vertebrae via crura.

  • Pierced by three openings (described later).


Central tendon5 l.jpg

Central Tendon

  • Three parts to central tendon:

    Right:

    Largest part.

    Middle:

    Left:

    Smallest part.

  • Fig. 2.71


Crura l.jpg

Crura

  • Muscular pillars

  • Originate from lumbar vertebrae:

    Right from L3.

    Left from L2.

    Right swings left and forms a weak sphincter around the esophagus.


Arcuate ligaments l.jpg

Arcuate Ligaments

  • Median:

    Around aortic opening.

    Bridges proximal ends of crura.

  • Medial:

    From deep fascia of psoas major muscle.

    From transverse process to body of L1.

  • Lateral:

    From deep fascia of quadratus lumborum muscle.

    From transverse process of L1 to rib 12.


Diaphragm openings l.jpg

Diaphragm Openings

  • Caval opening:

    Level T8

    Inferior vena cava; right phrenic nerve

  • Esophageal opening:

    Level T10

    Esophagus; vagus nerves

  • Aortic opening:

    Level T12

    Aorta; thoracic duct; azygos vein


Diaphragm innervation l.jpg

Diaphragm Innervation

  • Phrenic Nerve

  • C3-5


Diaphragm arterial supply l.jpg

Diaphragm Arterial Supply

  • Superior aspect:

    Pericardiacophrenic artery from IT.

    Musculophrenic artery from IT.

    Superior phrenic artery from aorta.

  • Inferior aspect:

    Inferior phrenic artery from aorta.


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